The Covid‐19 pandemic has concentrated bioethics attention on the “lifeboat ethics” of rationing and fair allocation of scarce medical resources, such as testing, intensive care unit beds, and ventilators. This focus drives ethics resources away from persistent and systemic problems—in particular, the structural injustices that give rise to health disparities affecting disadvantaged communities of color. Bioethics, long allied with academic medicine and highly attentive to individual decision‐making, has largely neglected its responsibility to address these difficult “upstream” issues. It is time (...) to broaden our teaching, research, and practice to match the breadth of the field in order to help address these significant societal inequities and unmet health needs. (shrink)

Bioethics needs an expanded moral vision. It is now time for bioethics to take full account of the problems of health disparities and structural injustice that are made newly urgent by the COVID-19 pandemic and the effects of climate change. Nancy M. P. King, Gail E. Henderson, and Larry R. Churchill make the case for a more social understanding and application of justice, a deeper humility in assessing expertise in bioethics consulting, a broader and more relevant research agenda, (...) and greater appreciation of the profound health implications of global warming. (shrink)

The three important target articles make a strong case for regarding racism as a public health crisis. Each calls for advocacy by the bi...

ABSTRACT:Good science fiction can be a successful vehicle for portraying justice. Science fiction can stimulate moral imagination in much the same way as the most effective justice theories, connecting the world in which we live with a range of alternative futures deliberately and creatively made plausible. A selective examination of classic and recent science fiction stories and novels provides contextual framing for considering questions of climate justice, virtuous personal action in the face of structural injustice, and the problem of what (...) justice means when some people are regarded as “other.” By connecting compelling images of individual responsibility with the complex challenges posed by striving for social justice, science fiction can also help render justice work appealing and achievable—an essential step that is reinforced in closing by a brief set of maxims. (shrink)

In March 1996, the General Accounting Office (GAO) issued the reportScientific Research: Continued Vigilance Critical to Protecting Human Subjects.It stated that “an inherent conflict of interest exists when physician-researchers include their patients in research protocols. If the physicians do not clearly distinguish between research and treatment in their attempt to inform subjects, the possible benefits of a study can be overemphasized and the risks minimized.” The report also acknowledged that “the line between research and treatment is not always cleartoclinicians. Controversy (...) exists regarding whether certain medical procedures should be categorized as research.”This problem currently plagues gene transfer research. A few months prior to the GAO report, an ad hoc committee appointed by National Institutes of Health (NIH) Director Harold Varmus expressed similar concerns in its assessment of NIH investment in research on gene therapy. (shrink)

In March 1996, the General Accounting Office (GAO) issued the reportScientific Research: Continued Vigilance Critical to Protecting Human Subjects.It stated that “an inherent conflict of interest exists when physician-researchers include their patients in research protocols. If the physicians do not clearly distinguish between research and treatment in their attempt to inform subjects, the possible benefits of a study can be overemphasized and the risks minimized.” The report also acknowledged that “the line between research and treatment is not always cleartoclinicians. Controversy (...) exists regarding whether certain medical procedures should be categorized as research.”This problem currently plagues gene transfer research. A few months prior to the GAO report, an ad hoc committee appointed by National Institutes of Health (NIH) Director Harold Varmus expressed similar concerns in its assessment of NIH investment in research on gene therapy. (shrink)

In March 1996, the General Accounting Office issued the report Scientific Research: Continued Vigilance Critical to Protecting Human Subjects. It stated that “an inherent conflict of interest exists when physician-researchers include their patients in research protocols. If the physicians do not clearly distinguish between research and treatment in their attempt to inform subjects, the possible benefits of a study can be overemphasized and the risks minimized.” The report also acknowledged that “the line between research and treatment is not always clear (...) to clinicians. Controversy exists regarding whether certain medical procedures should be categorized as research.”This problem currently plagues gene transfer research. A few months prior to the GAO report, an ad hoc committee appointed by National Institutes of Health Director Harold Varmus expressed similar concerns in its assessment of NIH investment in research on gene therapy. (shrink)

This article is the lead piece in a special report that presents the results of a bioethical investigation into chimeric research, which involves the insertion of human cells into nonhuman animals and nonhuman animal embryos, including into their brains. Rapid scientific developments in this field may advance knowledge and could lead to new therapies for humans. They also reveal the conceptual, ethical, and procedural limitations of existing ethics guidance for human‐nonhuman chimeric research. Led by bioethics researchers working closely with an (...) interdisciplinary work group, the investigation focused on generating conceptual clarity and identifying improvements to governance approaches, with the goal of helping scholars, funders, scientists, institutional leaders, and oversight bodies (embryonic stem cell research oversight [ESCRO] committees and institutional animal care and use committees [IACUCs]) deliver principled and trustworthy oversight of this area of science. The article, which focuses on human‐nonhuman animal chimeric research that is stem cell based, identifies key ethical issues in and offers ten recommendations regarding the ethics and oversight of this research. Turning from bioethics’ previous focus on human‐centered questions about the ethics of “humanization” and this research's potential impact on concepts like human dignity, this article emphasizes the importance of nonhuman animal welfare concerns in chimeric research and argues for less‐siloed governance and oversight and more‐comprehensive public communication. (shrink)

The purpose of this text is to give physical therapy students and clinicians a lens through which to analyze contemporary ethical challenges.

A Case-Based Approach to Learning Ethics in Physical Therapy. Ethics in Physical Therapy utilizes a unique case-based approach to teach students and clinicians how to apply theoretical concepts to real-world situations. The cases were carefully selected to encourage thinking and discussion. The accompanying text provides a framework to answer the "should" questions, such as "What should I do?" and "How should I act?" The format provides the opportunity to move beyond the individual realm, when appropriate, resolving issues within an institutional (...) or societal perspective. The text is divided into two sections: "Ethics for the Physical Therapist" and "Types of Ethical Decisions: Case Analysis." They are designed to integrate with one another, but, each section can also be used separately. Part I provides more didactic, foundational material, while Part II strives to apply ethical decision-making tools to relevant cases in physical therapy practice, with the second section focusing on case analyses. The purpose of Ethics in Physical Therapy is to give students and clinicians a lens through which to analyze contemporary ethical challenges. Philosophical theory within the text is limited to that which can be applied practically in the clinical setting. This book is not intended to be a work on ethical behavior, rather, it is designed to provide students and clinicians with a framework in which to approach the uncertainty of ethical decision making with tools to aid their inherent judgment. (shrink)

Problem: Medical student mistreatment, as well as patient and staff mistreatment by all levels of medical trainees and faculty, is still prevalent in U.S. clinical training. Largely missing in interventions to reduce mistreatment is acknowledgement of the abuse of power produced by the hierarchical structure in which medicine is practiced. Approach: Beginning in 2001, Yale School of Medicine has held annual “Power Day” workshops for third year medical students and advanced practice nursing students, to define and analyse power dynamics within (...) the medical hierarchy and hidden curriculum using literature, guest speakers, and small groups. During rotations, medical students write narratives about the use of power witnessed in the wards. In response to student and small group leader feedback, workshop organizers have developed additional activities related to examining and changing the use of power in clinical teams. Outcome: Emerging narrative themes included the potential impact of small acts and students feeling “mute” and “complicit” in morally distressing situations. Small groups provided safe spaces for advice, support, and professional identity formation. By 2005, students recognized residents that used power positively with Power Day awards and alumni served as keynote speakers on the use of power in medicine. By 2010, departments including OB/GYN, surgery, psychiatry, and paediatrics, had added weekly team Power Hour discussions. Next Steps: The authors highlight barriers, benefits, and lessons learned. Barriers include the notion of clinical irrelevance and resistance to the word “power” due to perceived accusation of abuse. Benefits include promoting open dialogue about power, fostering inter-professional collaboration, rewarding positive role modelling by residents and faculty, and creating a network of trainee empowerment and leadership. Furthermore, faculty have started to ask that issues of power be addressed in a more transparent way at their level of the hierarchy as well. (shrink)

Wentzel van Huyssteen's Gifford Lectures, published as Alone in the World? Human Uniqueness in Science and Theology, accomplish critical and constructive thinking about interdisciplinary reflection on science and religion and about the meaning of human uniqueness. One approach to discussion of van Huyssteen's text entails consideration of three issues: the contextual character of research on humans and animals, the difficult problem of defining uniqueness, and the important consequences of exploring human uniqueness. Evolutionary biology and primatology contribute specific scientific insights.

Ecofeminism refers to feminist theory and activism informed by ecology. Ecofeminism is concerned with connections between the domination of women and the domination of nature. Although ecofeminism is a diverse movement, ecofeminist theorists share the presuppositions that social transformation is necessary for ecological survival, that intellectual transformation of dominant modes of thought must accompany social transformation, that nature teaches nondualistic and nonhierarchial systems of relation that are models for social transformation of values, and that human and cultural diversity are values (...) in social transformation. Ecofeminist theology, ethics, and religious perspectives are particularly concerned with the integration of science and religion. Examples of religious or spiritual ecofeminisms are North American Christian ecofeminism, North American womanist Christian theology, neopagan Wiccan ecofeminism, Native American ecofeminism, and Third World ecofeminism. (shrink)

In this timely, thoughtful book, which goes to the heart of feminist concerns in the context of larger social, ecological, and theological issues, Nancy R. Howell proposes an ecofeminist worldview based on the organic-relational philosophy of Alfred North Whitehead. In particular, the book explores the ways in which Whitehead's philosophy can help to establish interrelationships among various women's communities, the relationship between humanity and nature, and the theological process of relating the world to God. Howell strives to develop principles (...) that are compatible with the wide spectrum of women's voices from different racial backgrounds and social strata. Specifically, she moves beyond mere acknowledgment of differing perspectives within the woman's movement and seriously engages criticisms of race-privileged white feminism by African American and Latin American activists. A Feminist Cosmology calls for a self-critical reformation of feminist thought based on a more inclusive framework, one that takes into account the diversity of relationships among women, the deep interdependence of humanity and the ecosystem, and ultimately the variety of theological perspectives relating the world to God. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Buddhist-Christian Dialogue in an Age of ScienceNancy R. HowellBuddhist-Christian Dialogue in an Age of Science. By Paul O. Ingram. Lanham, MD: Rowman and Littlefield, 2008. 155 pp.To my knowledge, Paul Ingram’s Buddhist-Christian Dialogue in an Age of Science undertakes a new project: Systematic and methodological analysis of how Buddhist-Christian dialogue can be shaped by focus on the natural sciences, or, alternatively, how science-religion dialogue can be enhanced through (...) interreligious dialogue. Either description is appropriate and remarkable in light of the accomplishments of a modestly brief book. While I have participated in multireligious dialogue on science, never have I seen a cogent guide for undertaking the conversation until Ingram’s book appeared.The thesis of Ingram’s argument is that bringing the natural sciences into Buddhist-Christian dialogue promises mutual creative transformation of Buddhism, Christianity, and the natural sciences (p. 2). In such a compact sentence is much to be explained, and Ingram unfolds the meaning of the thesis particularly in chapters 2 and 6. Ingram describes both Christian and Buddhist understandings of the relationship of science and religion, as well as approaches to dialogue between the religions. Ingram’s book is focused on conceptual interreligious dialogue, which engages theological and philosophical worldviews and self-perceptions and how the religions can learn from each other (p. 10). (Not surprisingly, the Whiteheadian Ingram names John B. Cobb Jr. as an exemplar for conceptual dialogue.) Ingram proposes that Buddhism and Christianity enter conceptual dialogue with the natural sciences, with the goal of mutual creative transformation (p. 15). Creative transformation is a Whiteheadian concept defined as “a process of growth and novelty,” “the essence of life itself,” and “a process that alters the nature of...elements without suppressing or destroying them” (p. 120). Creative transformation is possible when all participants in the dialogue Ingram proposes have some particularity to contribute, so the challenge in Ingram’s book is to describe how Buddhism and Christianity have particular contributions to make to dialogue about the natural sciences, as well as whether the sciences can be creatively transformed by encounter with world religions (p. 121).The structure of the book, which includes chapters on Buddhist and Christian encounter with cosmology, evolutionary biology, and cognitive sciences, provides specific awareness of the literature about how the religions have individually engaged the natural sciences. Ingram presupposes and names the awe, wonder, and reverence generated by the natural sciences, whose insights shape our worldviews and inform understanding of ourselves. Scientific insights, according to Ingram, generate “an urgent cultural need to reflect thoughtfully and critically on these changes and challenges in a constructive dialogue involving the world’s religious traditions” (p. 130). Ultimately the dialogue must overcome compartmentalized, disciplinary knowledge and engage in integrative, inclusive, multireligious dialogue (p. 130). Ingram envisions that the “purpose of interdisciplinary and interreligious dialogue is mutual creative transformation” (p. 130), which can occur only when the complex details of the sciences and Buddhist and Christian traditions are honored. [End Page 209]Following Ian Barbour, Ingram recommends a critical realist stance, which he adopts as his approach. He understands critical realism to mean that scientific, Christian, and Buddhist conclusions, practices, and worldviews intend to correspond with reality. However, correspondence to reality, “the way things really are,” (p. 37) must be understood provisionally, so that conclusions and worldviews must always be subjected to correction and reformulation. In Ingram’s view, the need for reformulation is the justification for Buddhist–Christian–natural science dialogue because no single view “possesses the final truth about the natural order or ultimate reality” (p. 37). Buddhism, Christianity, and the natural sciences offer distinctive expressions of the search for truth, which (Ingram avers) “requires...some form of mutual critical integration” in the process of dialogue (p. 37).Concentrating more on the constructive methodology of the book (rather than the three chapters with examples of engagement of the natural sciences with Buddhism and Christianity), I want to address one feature of the argument. Chapter 1, “A Common Cosmology,” proposes appropriately that “[while] scientific cosmology cannot simply replace the basic content of religious creation myths, current scientific cosmology can clarify and transform religious creation myths” (p... (shrink)

Multiple dimensions and textures of transcendence are evoked not just by reflection on humans in their relationship with God and community but also by encounter with bonobos—primates that are very close genetic kin with humans. The promise for theological reflection is rooted in bonobo social adaptation as a highly cooperative species. Bonobo sexual behavior accompanies and expresses a high level of social intelligence. The point of my project is not a scientific one intended to argue persuasively for individual self-awareness or (...) self-transcendence in bonobos. Instead, it emphasizes connectedness, interdependence, and sociality as windows on transcendence. Such a view does not require consciousness or intellectual recognition of self-in-relation, but it certainly presumes embodiment of self-in-relation. Various textures of transcendence reflect multidirectional relationships among Pan paniscus (bonobos), Homo sapiens , and the Sacred. (shrink)

Accession Number: ATLA0001713221; Hosting Book Page Citation: p 945-961.; Language(s): English; General Note: Bibliography: p 961.; Issued by ATLA: 20130825; Publication Type: Essay.